Prepectoral breast reconstruction with complete anterior implant

Background Several studies have discussed various methods of prepectoral direct-to-implant (DTI) breast reconstruction using an acellular dermal matrix (ADM) prosthesis to achieve full coverage. However, methods for anterior coverage have rarely been reported. In this study, prepectoral DTI breast reconstruction with complete anterior implant coverage was performed using a square piece of ADM. This study aimed to introduce our prepectoral DTI technique and determine its functional and cosmetic outcomes as well as compare them with those of existing subpectoral DTI techniques. Methods This prospective comparative study focused on 29 patients (35 breasts) and 34 patients (35 breasts) who underwent breast reconstruction via subpectoral implant insertion (control group) and anterior coverage prepectoral implant insertion (anterior coverage group), respectively. Postoperative complications were noted, and breast symmetry was evaluated using the Vectra H2 three-dimensional scanner. The modified Kyungpook National University Hospital Breast-Q (KNUH Breast-Q) scale was used to assess the patient’s subjective satisfaction with the reconstruction and postoperative quality of life. Results No remarkable differences in terms of complications (seroma, skin necrosis, nipple–areola complex necrosis, hematoma, capsular contracture, and infection) were noted in both groups. Compared with controls, considerably better results were observed among those in the anterior coverage group in terms of the mean drain removal period. Furthermore, those in the anterior coverage group showed greater symmetry on three-dimensional scans than the controls; however, this was not statistically significant. Subjective satisfaction and postoperative quality of life measured using the KNUH Breast-Q scale were not significantly different between both groups. Conclusions Considering its stability, faster recovery time, and cosmetic benefit, prepectoral breast reconstruction with anterior implant coverage using a single, large ADM is a good choice to perform breast reconstruction with implant insertion in patients who have undergone mastectomy. Level of evidence: II.

Breast Reconstruction – Dimitri, J. Koumanis MD, Cosmetic Surgeon Albany, Saratoga Springs, Queensbury, New York

Survey participant selection process.

Preparation of the superior edge of ADM-based pouch. The superior edge

Evaluation of capsular contracture following immediate prepectoral versus subpectoral direct-to-implant breast reconstruction

PDF) Prepectoral breast reconstruction with complete anterior implant coverage using a single, large, square-shaped acellular dermal matrix

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Prepectoral breast reconstruction with complete anterior implant coverage using a single, large, square-shaped acellular dermal matrix, BMC Surgery

Implant Placement (Above or Below the Muscle) - Friedman Center

Preoperative images reflecting the implant selection method. BW and BH

PDF] A Guide to Prepectoral Breast Reconstruction: A New Dimension to Implant‐based Breast Reconstruction

Prepectoral Implant Based Reconstruction Melbourne, VIC

Pre-pectoral implant-based breast reconstruction after mastectomy: a narrative review - Di Micco - Annals of Breast Surgery